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Comparative study of continuous epidural 0.1% Ropivacaine versus 0.125% Bupivacaine on post-operative pain relief following total knee replacement

Jigna Shah, Ruchin Parikh.

Abstract
Background: Bupivacaine has similar pharmacodynamic and pharmacokinetic properties to Ropivacaine but has shown to have higher cardiac and CNS toxicity and greater separation between sensory and motor block.

Objective: To compare the efficacy of continuous infusion of epidural Ropivacaine and Bupivacaine for post-operative analgesia, study the effect of two drugs in maintaining the hemodynamic stability and post-operative complications of both the drugs.

Materials and Methods: 60 patients were randomly allocated to receive epidural, continuous infusion of 0.1% Ropivacaine (Group A), or continuous infusion of 0.125% Bupivacaine (Group B).

Result: Ropivacaine group has less fluctuation in pulse, systolic blood pressure, diastolic blood pressure, oxygen saturation than Bupivacaine group and difference was statistically significant. Pain relief was batter among Bupivacaine group of patients as compared to Ropivacaine group. And difference was significant. Pain appears early in group of Ropivacaine group as compared to group of Bupivacaine.

Conclusion: 0.1% Ropivacaine produced excellent post-operative epidural analgesia, which was clinically indistinguishable from a 0.125% concentration of Bupivacaine with the advantage of hemodynamic stability, fewer incidences of complication or adverse effect and patient’s satisfaction.

Key words: Ropivacaine, Bupivacaine, epidural analgesia, hemodynamic stability


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